| Anthem Blue Cross (HMO, PPO, EPO) |
| Lorbrena (lorlatinib) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: 1 syringe per 28 day(s).
- Quantity Limit: 2 tablets per 1 day(s).
- Quantity Limit: limit maximum 1 EA PER 91 day(s)
- PA_APPLIES
- Quantity Limit: 1 tablets per 1 day(s).
- PA**;
|